I’ve been writing for years that anti-vaccine advocacy has nothing to do with vaccines or even children. At its heart, anti-vax is a form of social identity; it’s all about parents and how they wish to view themselves.

This paper argues that the decision to vaccinate or not is an inherently social one, not a matter of pure individual rationality. This is a novel approach to engaging with what is often characterised and studied as an individual decision.

It’s ironic that while anti-vaxxers like to preen about their independence from authority, they are desperately dependent on in-group validation.

In other words, vaccine refusal has nothing to do with understanding of science (although anti-vaxxers do have a deficient understanding of science) and is therefore not amenable to change by improving knowledge about vaccines. It’s about group-think, belonging and a sense of empowerment derived from opposing the majority. It’s ironic that while anti-vaxxers like to preen about their independence from authority, they are desperately dependent on in-group validation.

…[V]accine hesitant people are often found in tight-knit geographical communities, they take comfort and inspiration from people who share similar beliefs all around the world, connected via the internet, with whom they feel a sense of kinship as an enlightened but besieged minority… [T]he social context of vaccination puts choices beyond the realm of pure individual rationality. The decision to vaccinate or not is tied to how individuals view society and their place in it, the social groups they value, and the shared worldviews of social groups they belong to.

But don’t anti-vaxxers come from widely different economic, social and religious backgrounds? They do, but the authors argue that these are simply tribes within the larger group.

There are various worldviews among these tribes, some of which are affluent and some of which reject materialism; some of which follow traditional religion and some of which favour non-traditional forms of spirituality. However, we suggest that all are formed in opposition to what they perceive as the damaging practices of modern mass society.

The commonality between the distinctive tribes is a “natural” approach to parenting and lifestyle.

People who adhere to this worldview value their own expertise and that of alternative health practitioners over mainstream medical and scientific expertise. They distrust what they see as unthinking deference to industrialised, commodified and financially co-opted medicine, and do not believe that the vaccinating mainstream has any valid claim on them or their children… [They] appear to hold specific beliefs around the damage of mass society as it pertains to the realm of health, and the health of their children in particular. When it comes to this, they seemingly do not aspire to acceptance from mainstream society; rather, they define themselves in opposition to it.

The authors use the insights of social identity theory (SIT):

SIT posits that individuals see the social world in terms of in-groups and out-groups, develop favourable biases towards members of their own in-groups, and make judgments about others based on this in-group bias.

That’s a remarkably apt description of anti-vax groups.

Ultimately, it’s about parental self-esteem, not vaccines and not children:

The individual drive for self-esteem is central to SIT. Individuals enhance their own self-esteem by their association with highly valued groups. They are therefore motivated to regard their own in-group highly, and to favour other members of that group. Degradation of out-group members may be a further means of enhancing in-group, and thus individual, self-esteem.

How are these groups created?

While historically this has relied upon physical proximity or tangible relationships, the internet and social media have opened up avenues for geographically disaggregated individuals to connect around ideas and practices.

The groups cohere around a particular cultural “style.”

[W]e posit that there is a recognisable identity to a central VHR tribe, referencing wellness and the pre-eminence of nature… [We] explore how this identity is reliant on particular resources. These resources enable an emphasis on individualism, which can be recognised as further attributes of this identity.

This style is closely tied to belief in “alternative” health, natural childbirth, breastfeeding, the centrality of nutrition.

Reich explicitly teased out how her mostly white, educated subjects in California saw feeding as “key to both their mothering and health promotion practice”, breastmilk was seen as conferring immunity, and on this basis mothers quasi-rationalised refusing vaccines, even while implicitly recognising that vaccination might be appropriate for other children. “[E]fforts to manage nutrition generally” were seen as “protective of […] children’s health”, whether because the mother took supplements during pregnancy or fed her child organic food.

Anti-vaxxers reject the notion that they have any responsibility to others:

To “live naturally”, one needs the resources of money or time, as we noted above; only then can one act and reason individually. This “me-first” perspective provides a salient rationale for dismissing the impact on others, as highlighting the special and unique properties of one’s own child makes it hard to justify population-level interventions…

In summary:

Vaccine hesitancy and refusal is also about one’s own self-image in relation to groups to which one perceives oneself as either belonging or proudly oppositional. Vaccine refusers possess the social or economic capital to define themselves against the mainstream, and seek to act according to their own beliefs and desires. Whether following a natural lifestyle and questioning big pharma, or using wealth to insulate one’s family from child care, bad food and “the riff raff”, VHR parents are able to separate themselves conceptually and physically from the rest of us.

Anti-vaxxers cling so desperately to their failed ideology, not out of concern for children’s health, but as a critical source of personal validation.

Hello, I am a big fan VAXXED from cover up to catastrophe. The untold story of vaccinations must be told.I myself will disclose that I believe safety should be our top ranging priority when administering vaccines and practicing medicine in general. All ethics I will mention further on in my literature must be carefully and elegantly followed in a rational, logical diplomatic manner by all health-caregivers including medical and paramedical personnel.

Facts to know,

Vaccines are an immunization (preventive medicine) procedure.

Vaccines do not make you healthier they only prevent you from getting sick, however you become susceptible to vaccine side effects after receiving a vaccine.

Making a safe vaccine

Vaccine manufacturing must be done so that a vaccine is safe even if it is more costly and inconvenient. Especially when the recipient of the vaccine is a youngster they must be as safe and effective as possible and must only be administered by a professional who has no financial or any other harmful unspecified or any undisclosed conflict of interest.

Administering vaccines

Vaccines must be given only if they are needed. Vaccines should not be given at an inappropriate age, meaning a baby getting a vaccine for something only an adult could contract. Vaccines should not be administered when the probability of a side effects from the vaccine outweighs the chances of contracting the disease you are intending to prevent. When vaccines are an option that is reasonable and it totally makes sense for you to get a vaccine, you and your health care provider or paramedic or doctor should follow these safety guidelines or measures to prevent the evil in the good meaning the side effects in the vaccine you are interested in getting for immunization against an infectious disease.

Always take into consideration the patient’s overall health and the health of each relevant part of the body often being the whole body.

Test a patient for overall body health this includes examining and documenting your nutrition intake and potential existing toxins in the body and responding accordingly to your findings within reason.

Always take into consideration synergistic toxicity and the synergistic effects that may occur.

Examine the patient with a cognitive test before and after the vaccine (the brilliant toxin).

When administering medicine even a vaccine include the 7 rights concept:

The concept of ‘The Seven Rights’, provides an effective tool that should be applied whenever medicines are administered or issued: the right medicine must be administered to the right person in the right dose at the right time via the right route, with the right documentation, and the client has the right to refuse

In the case of refusal, know other alternative solutions to achieve the same goal of immunity such as other ways to prevent contracting the disease this includes through diets and sanitation and raw cow milk or other options for example herbicides, supplements and nutraceuticals.

When we find a cure for autism, we will have no excuse not to vaccinate. When we are entering an era of autism pride and autism acceptance when you see a needle you better run.

Angela

Absolutely agree. It’s not just vaccination. These types are against almost everything mainstream. Take a look at a few prominent “crunchy” bloggers. They home birth, home school, are against modern dentistry, anti-GMO, etc.

I’m convinced that these types would be waiting in line for vaccines if the majority of scientists were against them. If the mainstream said vaccines are dangerous, it would be the new homeopathy for the crunchy set.

swbarnes2

What I predict will happen is science will come up with some new kind of technology, like nanoprobes, or something like that, and then vaccines will be the crunchy alternative. ” People have been using vaccines to protect from bacteria for hundreds of years, to elicit the body’s extraordinary self-healing pathways in a totally natural way. “

KeeperOfTheBooks

Some of them, at least, seem to have the reflexive assumption that if everyone else does X normal/accepted thing because of externally-imposed rules and suggestions, then it’s a Blow For Freedom (TM) to do the exact opposite, never mind what the normal/accepted thing is, or why it’s in place.
My father passed away earlier this year, which was a catalyst for me to reflect on some of the more screwed-up stuff he espoused. One of those overarching ideas–he was a far-right conservative–was that “they”–usually “those radical feminazi bitches”–couldn’t tell HIM what to do, because NOBODY got to tell him what to do!
In retrospect, I wish there was some way to say, “Look, dad, you do on occasion run into the nutjob who seriously thinks that, say, all heterosexual sex is rape, but generally, and yes, that includes things like basic hygiene, food safety, traffic laws, and many social norms, it’s just not an eeeevil feminist conspiracy to control you.”
Of course, this probably would have been Proof that I’d espoused evil, radical, feminist philosophy. It would be right up there with suggesting that the recommendation to wash your hands after handling raw meat wasn’t actually a conspiracy by the local radical feminists at the health department to make one’s life overly complicated, but a recommendation that could, y’know, prevent all sorts of Fun With E.coli.
*sigh*

Seeing Clearly

Some people are like that, however this propaganda article omits vaccine conflicts of interest and potential side effects if given irresponsibly. This article is a hypocritical and bias as it gets.

Christopher Hickie

From my own personal experience, those parents thoroughly entrenched in these non-vaccinating clusters almost never leave their tribe. And in the US, thanks to the proliferation of anti-vaccine physicians, these tribes can pretend to follow the (pseudo)science of these quack physicians, making it easier for them to grow their tribes as they steadily continue to do.

Susie White

I am one of the lucky few that broke away after nearly two decads of being indoctrinated. It is a cult.

Russell Jones

It’s hard to dispute just how well the basic tenets of social identity theory fit here.

Some folks mistakenly view anti-vaxxism as solely an Alex Jones wingnut whackadoo phenomenon. It certain is that in part, but there’s a lot more to it.

The anti-vaxxers I’ve encountered are mostly well-educated hippies and hippie wanabees who are generally reasonable about other topics. Safely ensconced in a bubble of health generated largely by modern medicine, they anthropomorphize and worship all things “natural,” oblivious to or hand-waving away the fact that the bubble of health in which they live was generated largely through unnatural means (although human intellect, which is responsible for modern medicine generally and vaccines in particular is entirely natural) and would burst pretty goddamn fast if we all collectively abandoned those means.

Anti-vaxx research, such as it is, appears to have developed along the same lines as “creation science” research. One creationist pens and post online a “research” piece purporting to establish that the universe is 6,000 years old or some such. Creationist No. 2 writes his own “reseach” piece, citing Creationist No. 1’s “research” as authority. Along comes Creationist No. 3, who now has two “research” pieces to cite. So it goes until you’ve got a self-sustaining circle of anti-scientific bullshit that just keeps widening.

Nowadays the anti-vaxx pieces available online are as numerous as grains of sand in the Sahara. Anyone who’s inclined to do so can publish a new anti-vaxx “research” piece citing dozens and dozens of prior “research” articles in support of their thesis. It’s a bubbling cauldron of confirmation bias and the Dunning-Kruger effect.

Everyone gets something out of the current state of affairs. Folks like not-a-Dr. Andy Wakefield get sizeable annual incomes. The rank-and-file get a sense of belonging along with abundant food for their preexisting beliefs about how the world works.

Educated though many anti-vaxxers are, it’s amazing how easily duped so many of them are. I know some of the above-referenced hippie wanabees who detest everything Trump purports to stand for, yet voted for him anyway because he tweeted some dumbass nonsense about vaccines and autism.

I shamefully confess that I’m having a lot of fun rubbing these folks’ noses in the fact that Trump trolled the hell out of them. Trump’s FDA chair is as beholden to Big Pharma as anyone who’s ever held the job, and has stated multiple times that there’s absolutely no causal connection between vaccines and autism. The Trump-appointed Surgeon General and CDC Director are heavily pro-vaxx as well.

It’s more than a little unseemly loling at anti-vaxxers for getting trolled, but hey, with things so jacked up that POTUS is telling the nation with a straight face that actual, literal Nazis are “good people,” ya gotta take your little moments of enjoyment wherever ya find ’em.

Amber B

Sadly I have a friend that refused to vax her boys. She argued her choice with many people and her go-to attitude was against it because she was told to.
Very similar to a little kid refusing to eat her veggies she refused to protect her two boys. She identifies with being anti-government. If they TELL her to do it she doesn’t want to. She feels that to live in America means to make all her own decisions…such as to not wear a seatbelt or vax her children. It’s truly sad. Even when presented with health facts about the childhood diseases she insisted that the facts we’re fake. That the government wanted to control us and her proof was that these vaccinations were required to attend schools. I pray her boys never catch anything.

EmbraceYourInnerCrone

I get really mad at people who do this. They want all the advantages of being part of a modern, technologically advanced society (hospital ERs when they break bones or crash their cars, health care, affordable medications, good roads, a fire department that shows up when their house is on fire, cell towers, electricity coming to their house, water and sewer lines that are connected to their house, water that is safe to drink) but they don’t want to hold up their end of the social contract: pay taxes, vaccinate your kids, DON’T send your sick kid to school or day care AND DON’T bring your sick self to work and cough on me-I know that one is harder as many people don’t have a choice.

Cat10

I believe that in a heart-beat. We used to live in Madison, WI and the vaccination rates among the city’s highly educated population was pretty low. The crunchy, Subaru Outback-driving and attachment-parenting Moms did not vaccinate. Loudly declaring one’s opposition to vaccinations in public gatherings (e.g. the playground, the Mommy-and-me Yoga class) was a marker of social class and “education” (“I did my research and I am skeptical of the available evidence supporting vaccinations, bla bla”), as was shopping in the local organic produce co-op or outfitting their kids in top-of-the-line recreational gear.
When I first visited a pediatrician after my son was born, I figured I save us both some time and just let her know that I feel strongly about my kids getting all vaccination ON TIME. She just smiled and said, “I love it!”. I figure she had her fair share of grief about parents not vaccinating their kids. Whooping cough, for example, was a thing in Madison.
I also think this happens because the rich and well educated tend to have access to top medical care and hence think these diseases don’t affect them. At least that’s what I gleaned from talking to some of these women. They are all for vaccinating the poor kids in Africa but just not their own kids.

Nikalix

“I did my research”

Only they never did. They just read blog posts from like minded people.

In my younger days I also had some anti-vax tendencies, at a certain age you question everything and conspiracy theories easily take root when you are in that age bracket when you think you know everything but have very little life experience.

Then I had kids and actually “did my research” and boy did those research completely eviscerated any myths the anti-vax conspiracy put forth.

No need to mention that all my kids are fully vaccinated. And I’m now allergic to the sentence “I did my research” used by some anti-vax loon who usually then proceed to prove how little “research” was actually done.

Russell Jones

> “Only they never did. They just read blog posts from like minded people.”

I had some lady tell me to do research because there really are HUGE benefits for BF. I responded I have done research and the actual benefits are small for term babies in first world countries. …Well, she didn’t respond back. Do they know how arrogant they sound when they say that. It implies that the rest of us are stupid or uneducated.

Charybdis

The lactivist from Down Under posted that “there are no ‘benefits’ to breastfeeding. Breastfeeding is the biological norm. Rather, there are risks involved when not breastfeeding.” But then she bangs on and on about “human milk contains many hundreds of thousands of distinct bioactive molecules that protect against infection and inflammation and contribute to immune maturation, organ development and healthy microbial colonization”.
Can they not HEAR themselves and notice the contradictions in those statements? Apparently not.

Petanque

I just laughed out loud – this article describes some members of my extended family to a T, and guess what, they all are committed Subaru Outback drivers too!

CSN0116

I’d like to see more discussion of hegemony. While the individual tribes may be comprised of separate and unique characteristics, anti vaxx was initiated by the ruling class.

But I find morbid hope in the authors’ thesis: you want to extinguish a sub culture or counter culture? Socially oppress and shame the shit out of them. Establish a ruling class-initiated social norm wherein these people are demonized and deemed dangerous. Legislate their behavior. Segregate them.

Such actions have wrongly but effectively oppressed populations for decades. If there’s anything we’ve learned from America’s effed up history…

Astonishing, ain’t it? Most of the anti-vaxxers I’ve encountered are reasonably intelligent, well-educated hippies and hippie wannabees. They can’t stomach anything Trump purportedly stands for, yet a surprisingly high percentage voted for him anyway because he tweeted some dumbass nonsense about vaccines and autism.

I am having fun rubbing these people’s noses in the fact that Trump trolled the hell out of them. Trump’s FDA commissioner has more ties to Big Pharma (the boogiest of all anti-vax boogiemen) that anyone else who’s ever had the job, and tells anyone who will listen – including the Senate committee that conducted his confirmation hearing – that vaccines definitely do not cause autism. The Trump-appointed Surgeon General and CDC director are also heavily pro-vaxx.

Yes, it’s cruel and more than a little unseemly to LOL at hippies who got trolled. But hey, in a time where the President of the United States comes right out and says – publicly and apparently in all seriousness – that actual, literal Nazis are “good people,” ya take your little moments of enjoyment wherever ya find ’em.

MassiveQuantitiesofPie

It’s not cruel or unseemly, it’s necessary. People that stupid and selfish need to be mercilessly shamed for their stupidity and selfishness, since it’s so harmful in this context.

I can understand why brainwashed right wing nutjobs might vote for him but people who hate everything else he stands for voting for him because he tweeted some stupid shit about vaccines and autism? How freaking stupid can one be? That deserves major trolling that never stops. At least not until they grow the hell up or stop voting.

Gæst

The only problem with that approach is that it will negatively effect their children as well, and they are innocent of any wrongdoing.

CSN0116

Oh, absolutely. Apologies, I was being intentionally overly pragmatic about it all.

My understanding is that high tension counter culture (sects), like the anti vaxx, tend to dissolve in one of two ways: 1) they don’t dissolve; they just morph into something different, often more extreme and hostile than the original, 2) they are eschewed via marginalization and oppression.

Social identites do not exist outside of groups or institutions. That is, your identity is defined by how you relate (or refuse to relate) to larger groups. If anti vaxx follows scenario #1 above, the individuals’ identities remain and even radicalize. If #2 plays out, without the group’s existence their identities cannot remain and anti vaxxers would _theoretically_ be far less of a threat.

(I’ve seriously thought about this article way too much today)

MassiveQuantitiesofPie

With parents like these, the kids are screwed anyway. Without severe social shame, their kids will grow up to be just as bad as them or worse. Social shame is all we have to deal with people who are so stupid and dangerous.

Roadstergal

Fascinating. As a tangent, this implies that Donald Trump has more in common with Lefty Marin Mamas than either group would care to admit…

mya

It’s not just leftys. A lot of military wives are the same way, and 99% of them are hardass conservatives. Thus why I don’t hang around my fellow military wives.

Who?

Interesting that they are involved with the military but also anti-establishment: a way of acting out, perhaps? That has to be a tough life.

KeeperOfTheBooks

It’s something I’ve noticed, too: you find a very strong intersection between far-right, fundamentalist Christians and far-left hippie types on vaccines, birthing, All Natcheral, etc. My theory is that in the former case, they seem to think (I grew up in such a circle) that God made us perfectly (all evidence to the contrary notwithstanding) and Evil Chemicals aren’t part of His plan, and you’re somehow getting closer to the way He thinks things ought to be by spurning them.
(Me, I’m still Christian, but I happen to think that vaccines and antibiotics are among the neater things in God’s creation, thanksverymuch.)
In the latter case, it’s more a situation of thinking the evil pharmaceutical companies are all out to make millions of bucks by making your kids sick, and you can just avoid all that by avoiding all the Evil Chemicals.
A pox, if you’ll forgive the term, on both their houses.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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